RESUMEN
In public health insurance programs, federal and state regulators use network adequacy standards to ensure that health plans provide enrollees with adequate access to care. These standards are based on provider availability, anticipated enrollment, and patterns of care delivery. We anticipate that the coronavirus disease 2019 pandemic will have 3 main effects on provider networks and their regulation: enrollment changes, changes to the provider landscape, and changes to care delivery. Regulators will need to ensure that plans adjust their network size should there be increased enrollment or increased utilization caused by forgone care. Regulators will also require updated monitoring data and plan network data that reflect postpandemic provider availability. Telehealth will have a larger role in care delivery than in the prepandemic period, and regulators will need to adapt network standards to accommodate in-person and virtual care delivery.
Asunto(s)
COVID-19 , Planificación en Salud , Accesibilidad a los Servicios de Salud/normas , Cobertura del Seguro/normas , Seguro de Salud/normas , Sector Público , Intercambios de Seguro Médico , Humanos , Cobertura del Seguro/legislación & jurisprudencia , Cobertura del Seguro/organización & administración , Seguro de Salud/legislación & jurisprudencia , Seguro de Salud/organización & administración , Medicaid/legislación & jurisprudencia , Medicare/legislación & jurisprudencia , Estados UnidosAsunto(s)
Determinación de la Elegibilidad , Cobertura del Seguro , Seguro de Salud , Medicaid , Humanos , Determinación de la Elegibilidad/organización & administración , Seguro de Salud/organización & administración , Medicaid/organización & administración , Estados Unidos , Cobertura del Seguro/organización & administraciónRESUMEN
The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). The MEPS is widely used to study how policy changes and major shocks, such as the COVID-19 pandemic, affect insurance coverage, access, and preventive and other health care utilization and how these relate to population health. We describe how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules. The impact of the pandemic on response rates varied considerably across the MEPS. Investigations to date show little effect on the quality of data collected. However, lower response rates may reduce the statistical precision of some estimates. We also describe several enhancements made to the MEPS that will allow researchers to better understand the impact of the pandemic on US residents, employers, and the US health care system. (Am J Public Health. 2021;111(12):2157-2166. https://doi.org/10.2105/AJPH.2021.306534).